Background:Carcinoma Gallbladder is one of the most common malignancies of the gastrointestinal tract having a very poor prognosis with a high incidence in North India. Untreated chronic symptomatic cholelithiasis is one of the main risk factors with a female predilection. Impaired gallbladder emptying during menses & pregnancy & higher incidence of gallbladder diseases in females with high parity & prolonged fertility have all indicated the gallbladder to be female sex hormone responsive. This has been supported by some studies & refuted by others. Therefore a consensus is largely lacking, forming which, can further help in studying the therapeutic implications of hormone modulators in gallbladder pathology and its progression to malignancy
Aim: 1. To detect estrogen & progesterone receptors in gallbladder diseases
2. Clinicopathologic significance of receptor expression with gender, menopausal status, association with gallstones, gallbladder malignancy & characteristics of gallbladder pathology
Methods: Hospital-based descriptive type of observational study including all cases of gallbladder disease undergoing surgical management in the Sawai Man Singh Medical College, Jaipur, India during the study period. Resected specimen were evaluated for presence of the receptors by Immunohistochemistry and clinical significance was evaluated.
Results: 92 cases of gallbladder disease were included. Age interval of the cases was from 18yrs (youngest) to 80yrs (oldest) with most of the cases clustered in the 4th decade of life. 72 cases had gallstone disease. 11 cases were malignant. Statistical significance for Estrogen receptor was not achieved but Progesterone receptor expression was statistically significant.
Conclusions:We conclude that significant progesterone receptor expression was noted and confirm that gallbladder is a female sex hormone responsive organ. A multicentric trial involving larger number of cases of gallbladder malignancies would go a long way in potentiating therapeutic applications of hormone modulators in their prevention, treatment or palliation.